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MANILA, Philippines — Warning that it entrenches patronage politics and undermines the country’s health insurance system, at least 72 medical and health professional organizations have denounced the P51.6-billion allocation for the Medical Assistance to Indigent and Financially Incapacitated Patients (MAIFIP) in the proposed 2026 national budget.
Health Professional Alliance convenor Antonio Dans said the groups were “outraged” after lawmakers allowed the allocation to pass despite a budget deadlock between the Senate and the House.
Dans, a clinical epidemiologist, said the alliance wants the MAIFIP either scrapped or gradually phased out, with its funding allotted instead to the Philippine Health Insurance Corp. (PhilHealth).
Calling MAIFIP an “epal fund,” he said the alliance is preparing a legal challenge before the Supreme Court in case the aid program, described by critics as a health pork barrel, is approved in its current state.
“Our reading is that the senators gave in to the P51 billion for MAIFIP, and 72 health care professional organizations, including the PMA and PCP, were outraged that this was allowed to happen,” he said in an interview on One News’ “Storycon” yesterday, referring to the Philippine Medical Association and Philippine College of Physicians.
MAIFIP, according to Dans, poses both legal and moral concerns, as patients in crisis are required to secure guarantee letters from politicians or local officials to cover hospital expenses.
“That is morally demeaning. When you are already in a health crisis, you still have to beg for additional funds. That should not be necessary,” he said.
He stressed that under the Universal Health Care (UHC) law, Philippine Health Insurance Corp. is meant to be the country’s primary health care payer, guided by evidence, cost-effectiveness, and approved treatment protocols—standards, he said, MAIFIP bypasses.
“Instead of rights-based coverage, MAIFIP creates a system of patronage where patients feel indebted to politicians,” Dans said.
The groups also warned that MAIFIP diverts funds from PhilHealth, which they said remains underfunded despite expanded benefit commitments.
Dans said they have appealed to President Marcos and Congress to abolish MAIFIP or gradually reduce its allocation until it is phased out.
“This is not just a legal failure. It is a moral failure,” he said, adding that the group is prepared to elevate the issue to the Supreme Court if the appeal is ignored.
Similar concerns were raised in the House of Representatives, with Gabriela Women’s Party Rep. Sarah Elago questioning the bicameral conference committee’s decision to further increase MAIFIP funding.
“On the first day that the Gabriela women’s party entered Congress, we already questioned the increase in the funds for MAIFIP because it is the source of patronage politics and it does not address the root cause of the problem in the health care system,” Elago said.
She said expanding MAIFIP fails to address Filipinos’ immediate health needs and instead perpetuates a system where access to medical assistance depends on political connections.
“Increasing funds that pass through guarantee letters is not the solution. It only strengthens patronage politics, while we lack enough hospitals, beds, facilities and health workers,” she said.
“The government must stop the patients from the long queuing just to decrease hospital bills a little. The budget must go directly to the public hospitals for the additional bed, facility, health workers, medicine and diagnostic,” she added.
Special provision
Amid growing backlash, Sen. Risa Hontiveros proposed inserting a special provision in the budget to earmark P15 billion—or 30 percent of the MAIFIP fund—for the zero balance billing (ZBB) program in local government unit-run hospitals.
“If this special provision is accepted in the budget, we can guarantee that P15 billion, or 30 percent of the P51 billion MAIFIP allocation, will go to LGU hospitals for free medical treatment under the ZBB program,” said Hontiveros, who chairs the Senate committee on health and demography.
The proposal, she said, would expand the ZBB program, which currently covers patients in basic or ward accommodations in Department of Health-run hospitals, to include LGU hospitals.
“Through my special provision, more Filipinos will be able to receive free hospitalization under the zero balance billing program because it will no longer benefit only patients in the 86 DOH hospitals, but also those served by the hundreds of LGU hospitals,” Hontiveros said.
Meanwhile, private hospitals are pushing for stronger PhilHealth support to reduce out-of-pocket costs for indigent patients, particularly those admitted beyond mandated charity beds.
The Private Hospitals Association of the Philippines Inc. (PHAPI) said it is negotiating a memorandum of agreement with PhilHealth to subsidize indigent patients admitted in private hospitals but not covered under the 10 percent authorized bed capacity reserved for charity cases.
“We have talked with PHIC regarding that problem, we are still trying to negotiate. Maybe we can go for it as long as they will subsidize beyond the 10 percent,” PHAPI president Dr. Jose Rene de Grano said.
Under Department of Health Administrative Order 2007-0041 and the UHC law, private hospitals are required to allocate at least 10 percent of their authorized bed capacity to indigent and financially incapacitated patients.
De Grano noted that when charity beds are full, patients may still be charged basic rates even if placed in private rooms—an arrangement that can strain hospital operations.
“If the patient requests admission in a basic accommodation and there are no longer available beds, we have to charge them a basic rate even if they stay in a private bed. That may compromise our operational costs,” he said.
PHAPI said some private hospitals are implementing the ZBB policy for charity beds, under which PhilHealth covers most or all costs for eligible patients to minimize out-of-pocket expenses, though the policy has yet to be fully adopted across all private facilities.
Apart from PHAPI and PhilHealth, the planned agreement will also involve the PMA and the Philippine Hospital Association.
House OKs AICS on final reading
In a separate development, the House approved on third and final reading House Bill 6636, which seeks to institutionalize the Department of Social Welfare and Development’s Assistance to Individuals in Crisis Situation program.
The measure, passed with a 270-8 vote, aims to convert AICS from an administrative mechanism into a permanent social protection program.
The bill sets eligibility criteria, strengthens safeguards against abuse, establishes grievance mechanisms and creates a centralized database to prevent duplication of aid. — Marc Jayson Cayabyab, Rhodina Villanueva and Delon Porcalla
